Giving birth in a different town to where you live - advice please!

[firsttimemama182]

Hello Everyone,
I'm new to Mumsnet! I have recently found out that I am pregnant for the first time and am cautiously optimistic (am only seven weeks!)
I have registered to have my maternal care at my local hospital and my booking appointment and scan aren't until end of December and end of January.

I am normally quite anxious anyway but after booking my local hospital a newspaper article popped up on my feed saying that the maternity units of my four local hospitals had recently been inspected that week and my closest had been rated inadequate, and the other three as requires improvement!

I will be a high risk pregnancy and as a result of my ethnicity am at a higher risk of maternal mortality. I am seriously considering moving my antenatal care to another town/city as a result of all the above. The hospital that I am considering is currently 1hrs drive/90 mins by train. I will also move to my mum's during the third trimester to be closer to that hospital.

Looking for advice from anyone else who has done something similar and what their experiences were? It's very early days and I might be reassured by the local team but am keeping my options open at the moment.

You'll probably find most maternity hospitals if inspected at the moment would be rated inadequate due to the midwifery crisis. I'm not saying this to worry you btw. Could you name the hospitals in question to see if there are posters on here that have recent experiences there?
If you're high risk you will likely be at the antenatal clinic a lot for all sorts of appointments, I don't think it would take me long to get fed up with a 2 hour round trip every couple of weeks.

Is it CQC that did the inspections? If so have a look online for copies of the reports, you might find that they were marked down for factors that either won't apply to you or aren't important to you.

I had my son at a University hospital in the nearest city, which was 1 hour away. One of the consultants there contributed to writing the NICE guidelines for the management of pregnancy for women with a genetic condition I have, and I wanted to be under her care (high risk pregnancy). I chose to give birth there and was monitored there but I had my midwifery appointments locally at my GP surgery.
It was all fine for me. I got some raised eyebrows from my managers at work because my appointments took longer, with the travel time, but this didn't bother me. Having the security that I was being followed up by the best possible consultant for me was worth it.

Congratulations on your pregnancy!

We live in between two hospitals and I opted for one that’s slightly further away. The only issues I found is that the community midwives that I saw serve the other hospital and there was always issues with communication between each. I was consultant led also so any updates from her were shared with the hospital and my GP but not the midwives as they use a different system. I also had to go to the hospital for EVERY blood test which was arduous but worth it as I wanted to give birth at the hospital. I had the option to see the midwives in the other town but when the visits are more frequent it’s such a trek to be doing a 40 mile round trip each time. There were also horrendous road works around the hospital which I was keen to avoid!

@firsttimemama182 definitely trust your gut and do your research. Not all hospitals are equal and you’re right to factor in reports into your decision making, IMO. I wouldn’t worry about the longer drive I think it would be worth it to be in an environment you’re more comfortable in with medics you trust

My first was supposed to be at my closest hospital which is 30mins away but when she decided to arrive they were full and the next closest available hospital was just over an hour away by car. It wasn't a super fun car journey but it was manageable. So if the hospital you want is an hour away I don't see why that would be an issue.

The only problem we had was our discharge was mismanaged as the hospital she was born at was all digital files and where she was supposed to be born was paper files so the information wasn't passed across properly. However if you're chosen hospital is the one you give birth at that shouldn't be an issue.

My nearest is 112 miles away 2 and half hours in a car. Done it 3 times for various reasons. I would 100% do it again for the safety.

I gave birth at a hospital about 50 minutes drive away rather than the one that was about 25 minutes away, for various reasons. The car journey there while in labour wasn't great fun - though that wasn't helped by my husband panicking every time I had a contraction because I went quiet and into myself and he was going "what is it? What's wrong?" until I could speak again and then I'd yell "I'm in bloody labour, that's what's wrong" - repeat for 50 minutes. He's not normally that daft, to be fair.

There was a bit of an issue in that the birth itself was an absolute shitshow and we were then stuck in hospital, with DD in NICU and me in ICU, for a while, and that was pretty stressful for DH who had to do quite a lot of travelling to us. BUT there was also a very nice country park next to the hospital so he had somewhere nice to walk out in to destress a bit when he needed it, which we wouldn't have had at the other hospital.

The only other issue I can think of was that everyone else in our NCT class gave birth at the closer hospital so didn't have the advantage of exchanging info about that. But that wasn't a huge deal.

Admin-wise it really wasn't problematic at all, and I'd thought it might be.

We actually moved areas when I fell pregnant because our closest 2 hospitals were both under investigation at the time for a high amount of maternal deaths. Zero regrets. Just make sure you're near enough when it comes to being in labour; you don't want to be stuck in a car for 50min whilst in labour.

I opted for the hospital in the next city rather than one of the hospitals where we live. It can create some communication problems between the community midwives and the hospital, no major issues there but there were some delays and a bit of faff with getting things organised e.g. the hearing test is done in the hospital just after birth in my city but done by community midwives in the city where he was born, so we got a bit stuck finding someone to do it, managed to figure it out but took a bit of chasing around.
The only other thing to consider is the time it will take you to actually get to the hospital when in labour and whether you really want to spend a lot of time labouring in the car/on the train. My labour ramped up quite quickly and it took us about 40 mins to get to the hospital, it was a bit uncomfortable being in active labour in the car for that long and I was pretty much ready to push when we got there, any quicker and he would have been born en route!

Oh sorry, just reread your OP and saw that you’ll be staying at your mums so the distance isn’t an issue.

I just wanted to add that I’m glad we picked the hospital further away. They looked after us really well and it’s important to be somewhere you trust will provide good care for you and your baby.

It should be ok if you are willing to do lots of travelling throughout pregnancy. Don’t forget postnatal care will be transferred to your local area team so you will still be seen by the midwives from your local hospital after birth. Also think about if your baby needed NiCU/SCBU and you are far away. Your partner may have to do a lot of travelling daily to see you and baby.
Also if you have a section, the journey home is pretty uncomfortable. I was discharged the day after my section and the 20 minute journey was just about doable. I was counting down every minute

@mummyh2016 Yes it was the CQC. I had read the report immediately and essentially it talks about being understaffed, lots of people leaving, the remaining midwives being overworked and not getting their breaks, and it taking them longer to recognise deteriorating patients. Not ideal!

@BlueSoul Thank you! This sounds like you made the right decision for you.

@Ameteurmum Yes that sounds tricky being across two teams. I will definitely discuss this with the midwife when I see her next week.

@HopefulRose Yes I just don't think I would forgive myself if something were to happen to me or the baby and I hadn't done everything in my power to give us the best chance.

[quote firsttimemama182]@mummyh2016 Yes it was the CQC. I had read the report immediately and essentially it talks about being understaffed, lots of people leaving, the remaining midwives being overworked and not getting their breaks, and it taking them longer to recognise deteriorating patients. Not ideal![/quote]
With the exception of the last point I think the rest of it is how most maternity units are at the moment, midwives are leaving in droves and they can't be replaced quick enough there have been some threads on here about the crisis.